About 16 years ago, my doctor told me I ought to cut back on sugar, because my blood sugar was getting up a little high. So I did. However, after a few years, I became diabetic anyhow. I was always curious what I could have done to avoid getting diabetes. I mean, even though diabetes is not the worst disease you could ever have, it’s still not fun.
Recently I heard a radio program where the lecturer had a very heavy accent. But by listening very closely, I figured out that “pre-diabetic” people had some choices to make to avoid becoming diabetic. But that’s not exactly what my doctors told me 16 years ago. I’m still trying to research what people should do—and what I should have done.
First of all, the old term my doctor used was “insufficient glucose tolerance.” This is not exactly helpful to most people who are not skilled at “doctor-speak.” So the medical community has dropped this phrase in favor of “pre-diabetic,” which is much clearer to the patient. This is especially important because there are so many overweight people who are pre-diabetic. (If your family history or genetics has diabetes, you could become diabetic without being overweight, but the smart money is on fat people to become pre-diabetic.)
If I would have had the full advantage of a modern pre-diabetic program, I would have been taught a complete program of what to do to avoid becoming fully diabetic. I was just warned to cut down on sugar consumption—fine—but was not taught any of the other parts. This would really be quite similar to what diabetic patients are told: to minimize the chances for getting diabetes, follow the advice for people who are diabetic. You might be able to back away from the problem:
Lose weight. Weight is a big part of the problem.
Get more exercise, most days a week. Don’t just sit down most of the day.
Cut down on all carbohydrates: sugar, starch, bread, rice, potatoes, pasta, etc. Avoid overeating.
Take it easy on the milk and yogurt and sweet fruit.
At that time I was slightly overweight, but I had good, strong (heavy) legs for strong hiking. I got good exercise with one hike each weekend, but not much during the week. This is not as good as keeping active all day, but most of us ain’t farmers, and that’s not easy. And I sure did like eating a lot of rice, potatoes, and seven kinds of pasta. These foods can push up your blood sugar just like sugar, except eating a lot of rice or pasta is not normally associated with a bad diet.
So I didn’t do a very good job of keeping my blood-sugar level down. And that made my “glucose tolerance” even worse, and my insulin output even worse, and there I went down the slippery slope. I have been taking various drugs to keep my blood-sugar level a little lower, and it is coming down.
If you are overweight, you may not exactly have to ask your doctor “Am I pre-diabetic?” You may be able to figure it out for yourself. Does your doctor ever screen you for blood sugar? Even if your blood sugar is not terribly high, you should consider this as a caution or a warning to avoid a diet that just pushes the blood sugar higher until you get in trouble. Is frequent urination or unexplained tiredness a problem?
Testing And Planning
There’s another test that most non-diabetic people don’t know about—the “A1c” test. It works like a three-month running-average blood-sugar test. If you ate very little starch or carbohydrates or sugar, six days a week, but binged on them one day of the week, you might pass a spot test, but your A1c would take the average of all those readings. So this test might give you a better warning. It’s the average that’s bad for you, and the A1c does respond to this average.
If you are told that you may be pre-diabetic, you should probably start on a diet very much like a diabetic person. This is not really any extreme diet, but a good, healthful balanced diet, with not too much carbohydrates (starches). That means not just cutting down on sugar, but also cutting back on large amounts of other carbohydrates such as potatoes, rice, bread, pasta, and other kinds of starch. Eat more veggies, etc.
You certainly don’t need to cut out carbs. That would be wrong. Just stop pigging out. (That’s a technical term that my doctor never used on me.) And cutting down on the carbs will also help you get your weight down, which is the other important thing. And, exercise a lot, as much as you can.
Then you might discuss this with your doctor, or with the nutritionist your doctor works with or recommends. You might also bring in your spouse to get the idea of what kind of cooking and diet will help you the most. Starving yourself for one meal and binging on the next meal is probably a bad idea.
My doctor did (16 years ago) warn me about cutting down on sugar, but not about the other carbohydrates. I don’t think he talked about the weight loss or the exercise.
So I’m smarter than I used to be. And my doctor is smarter than he used to be. And so are you! You have to help your doctors to process the raw data (how you feel good, or lousy). You may be the best observer of this data—and the best person to interpret it so your doctor can help you do the right thing.